Uveal melanoma is the most common primary intraocular malignancy in adults, characterized by an insidious onset and poor prognosis strongly associated with tumor size and the presence of distant metastases, most commonly in the liver. Contrary to most tumor identification, a biopsy followed by a pathological exam is used only in certain cases. Therefore, an early and noninvasive diagnosis is essential to enhance patients’ chances for early treatment. We reviewed imaging modalities currently used in the diagnostics of uveal melanoma, including fundus imaging, ultrasonography (US), optical coherence tomography (OCT), single-photon emission computed tomography (SPECT), fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), fundus autofluorescence (FAF), as well as positron emission tomography/computed tomography (PET/CT) or magnetic resonance imaging (MRI). The principle of imaging techniques is briefly explained, along with their role in the diagnostic process and a summary of their advantages and limitations. Further, the experimental data and the advancements in imaging modalities are explained. We describe UM imaging innovations, show their current usage and development, and explain the possibilities of utilizing such modalities to diagnose uveal melanoma in the future.

Uveal melanoma is the most common intraocular malignancy and arises from melanocytes in the choroid, ciliary body, or iris. The current eye-sparing treatment options include surgical treatment, plaque brachytherapy, proton beam radiotherapy, stereotactic photon radiotherapy, or photodynamic therapy. However, the efficacy of these methods is still unsatisfactory. This article reviews several possible new treatment options and their potential advantages in treating localized uveal melanoma. These methods may be based on the physical destruction of the cancerous cells by applying ultrasounds. Two examples of such an approach are High-Intensity Focused Ultrasound (HIFU)—a promising technology of thermal destruction of solid tumors located deep under the skin and sonodynamic therapy (SDT) that induces reactive oxygen species. Another approach may be based on improving the penetration of anti-cancer agents into UM cells. The most promising technologies from this group are based on enhancing drug delivery by applying electric current. One such approach is called transcorneal iontophoresis and has already been shown to increase the local concentration of several different therapeutics. Another technique, electrically enhanced chemotherapy, may promote drug delivery from the intercellular space to cells. Finally, new advanced nanoparticles are developed to combine diagnostic imaging and therapy (i.e., theranostics). However, these methods are mostly at an early stage of development. More advanced and targeted preclinical studies and clinical trials would be needed to introduce some of these techniques to routine clinical practice.

Neuroendocrine neoplasms (NENs) belong to a group of various tumours that can arise on many internal organs. Among NENs a large class of gastroenteropancreatic neuroendocrine tumours (GEP-NETs) can be distinguished, which comprise neoplasms arising from the gastrointestinal tract and pancreas. Therefore, this review provides the current status of the World Health Organization classification of GEP-NETs as well as an overview of their clinical presentation, diagnosis, and treatment methods. GEP-NETs are generally divided into 5 groups: pancreatic NETs (PanNETs), gastric NETs (G-NETs), duodenal NETs (D-NETs), jejunoileal NETs (Je-Ile NETs), and neuroendocrine neoplasms of the large intestine. Moreover, in each group several subtypes have been introduced according to cell differentiation, mitotic rate, and Ki-67 index. Low-and intermediate-grade GEP-NETs are well differentiated, have a mitotic rate under 20, and a Ki-67 index under 20%. High-grade GEP-NETs, however, are characterized by poor differentiation, mitotic rate over 20, and Ki-67 index over 20%. StreszczenieNowotwory neuroendokrynne (NENs) obejmują różnorodne guzy, które mogą powstać w obrębie wielu narządów wewnętrznych. Pośród NENs można wyszczególnić klasę nowotworów neuroendokrynnych trzustki i przewodu pokarmowego, określanych wspólnie jako GEP-NETs. Obecne kryteria klasyfikacji GEP-NETs są nieprecyzyjne i różnią się pomiędzy różnymi źródłami, dlatego celem pracy przeglądowej było opisanie jednoznacznych kryteriów diagnostycznych zaproponowanych przez WHO. Ponadto w artykule zawarto przegląd literatury dotyczący objawów, metod diagnostycznych oraz leczenia GEP--NETs. GEP-NETs zostały podzielone na pięć następujących klas: nowotwory neuroendokrynne trzustki (PanNETs), żołądka (G-NETs), dwunastnicy (D-NETs), jelita cienkiego i krętego (Je-Ile NETs) oraz jelita grubego. W każdej klasie wyróżniono kilka podgrup, opierając się na stopniu zróżnicowania komórek nowotworu, wskaźniku mitotycznym oraz wartości indeksu Ki-67. GEP-NETs niskiego i pośredniego stopnia zaawansowania są dobrze zróżnicowane, mają częstość podziałów poniżej 20, a wartość indeksu Ki-67 to poniżej 20%. GEP-NETs o wysokim poziomie zaawansowania cechują się niskim stopniem zróżnicowania komórek, wskaźnikiem mitotycznym powyżej 20 oraz wartością indeksu Ki-67 powyżej 20%.